Individual Financial Affidavit {17A-26}

17A-26, INDIVIDUAL FINANCIAL AFFIDAVIT, For this application, from this date and pursuant to section 4207 of the Business and Professions Code, I hereby authorize the California State Board of Pharmacy, or any of its authorized personnel, to examine and secure copies of financial records consisting of signature cards, checking and savings accounts, note and loan documents, deposit and withdrawal records, and escrow documents of my financial institution(s) or any financial records established in connection with this business. This authorization to examine records at any financial institution may occur at any time. I also authorize the Board of Pharmacy, or any of its authorized personnel, to examine and secure copies of any business records or documents established in connection with this business including, but not limited to, those on file with my bookkeeper. www.FormsWorkflow.com